| Step Up Care Of North Carolina Pc | |
|
176 Mine Lake Ct Ste 100 Raleigh NC 27615-6417 | |
| (718) 298-4375 | |
| Not Available |
| Full Name | Step Up Care Of North Carolina Pc |
|---|---|
| Speciality | Psychologist |
| Location | 176 Mine Lake Ct Ste 100, Raleigh, North Carolina |
| Authorized Official Name and Position | Dov Newmark (PRESIDENT) |
| Authorized Official Contact | 7182984375 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Step Up Care Of North Carolina Pc 27 Randolph Rd Howell NJ 07731-8611 Ph: (718) 298-4375 | Step Up Care Of North Carolina Pc 176 Mine Lake Ct Ste 100 Raleigh NC 27615-6417 Ph: (718) 298-4375 |
| NPI Number | 1841929395 |
|---|---|
| Provider Enumeration Date | 06/09/2022 |
| Last Update Date | 06/09/2022 |
| Certification Date | 06/09/2022 |
| Medicare PECOS PAC ID | 4486036878 |
|---|---|
| Medicare Enrollment ID | O20220802000558 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841929395 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| Provider Name | David S Bathory |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609800895 PECOS PAC ID: 3274531280 Enrollment ID: I20061129000098 |
| Provider Name | Lashanda Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154616332 PECOS PAC ID: 1254596877 Enrollment ID: I20120705000691 |
| Provider Name | Kelly Louise Charles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467791186 PECOS PAC ID: 8628294584 Enrollment ID: I20140729002713 |
| Provider Name | Amber Rowe Mikus |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912228016 PECOS PAC ID: 5193047074 Enrollment ID: I20141203001870 |
| Provider Name | Kara Rochon Holden |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285196980 PECOS PAC ID: 6204163348 Enrollment ID: I20190812002621 |
| Provider Name | Michelle Sadler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740842905 PECOS PAC ID: 0244663268 Enrollment ID: I20191205002099 |
| Provider Name | Rikki Martin Hester |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386288256 PECOS PAC ID: 0941634273 Enrollment ID: I20191219001895 |
| Provider Name | Lindsay Marie Allotey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619501202 PECOS PAC ID: 0749618825 Enrollment ID: I20200324001891 |
| Provider Name | Courtney Tierra Keith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770093452 PECOS PAC ID: 6901201607 Enrollment ID: I20210818002205 |
| Provider Name | Charisse N Fullwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154085629 PECOS PAC ID: 9931593936 Enrollment ID: I20220308000163 |
| Provider Name | Monica Summers Guidry |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659348282 PECOS PAC ID: 4486034816 Enrollment ID: I20220802002144 |
| Provider Name | Lethea Kate Pittman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417372491 PECOS PAC ID: 9032593215 Enrollment ID: I20220907002999 |
| Provider Name | Renee Susanne Mcguire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861141764 PECOS PAC ID: 8123404639 Enrollment ID: I20221006003553 |
| Provider Name | Rosette Joseph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598457996 PECOS PAC ID: 4183085590 Enrollment ID: I20230802000554 |
| Provider Name | Shavodka Nowacki |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386298115 PECOS PAC ID: 3375906845 Enrollment ID: I20230830004288 |
| Provider Name | Sasha Hamilton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508387960 PECOS PAC ID: 0547614166 Enrollment ID: I20230929001561 |
| Provider Name | Ewa Brennan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780847731 PECOS PAC ID: 0749349405 Enrollment ID: I20231024003471 |
| Provider Name | Shanice Pryce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447034533 PECOS PAC ID: 7113373226 Enrollment ID: I20231026000169 |
| Provider Name | George Shell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114324084 PECOS PAC ID: 5698113298 Enrollment ID: I20240402001434 |
| Provider Name | Tijuana Mcleod Crosby |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780722801 PECOS PAC ID: 9335587823 Enrollment ID: I20240403000909 |
| Provider Name | Janella Lynn Poda-henry |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538487228 PECOS PAC ID: 9739528274 Enrollment ID: I20240417002407 |
| Provider Name | Nancy Vue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255100814 PECOS PAC ID: 9335588425 Enrollment ID: I20240423000908 |
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